Implant Removal / Replacement

Capsulectomy and Breast Implant Exchange

10th March 2011

Implant Removal / Replacement

Capsular contraction following Breast Enlargement occurs in approximately 5% of people. Mr Richards shows how this is treated with total capsulectomy and placement of a new implant. For more information or should you wish to book a FREE Consultation with our specialist plastic surgeon, please call us on 01844 214362.

Transcript

Breast Implant Removal and Capsulectomy

Hello. My name is Adrian Richards. I’m a plastic and cosmetic surgeon and the Surgical Director of Aurora Clinics based here in the United Kingdom. In this video, I’m going to be taking you through an operation I performed today on a lady who had breast implants inserted in front of the muscle 12 years ago. The implants have developed Grade 3 capsules in that they’re firm, hard, and painful and with some distortion. I’m going to be performing an exchange of implant and a capsulectomy operation. A capsulectomy is a total removal of the capsule surrounding the implant, and I’ll show you that in the video.

This is just the beginning of the operation showing the area prepped and draped, and this is me just incising the old scar which was located in the inframammary fold.

The next stage is just to cut down with the electrocautery onto the capsule of the implant. So I just do that gently going through the fatty tissue of the breast there. You can see now that I’m actually down onto the capsule of the implant, and I will dissect all the way around the capsule so I can remove the capsule and the implant intact.

You can see here that’s the capsule surrounding the implant and the implant lies within that. Now I’m just cutting through the capsule and you can see free silicone within this area, so the implant was likely to be ruptured within the capsular which is a so-called intra-capsular rupture. And you can see that the capsule really does pull in that implant and constrict it, and this makes it firm and also distorts the shape making the implant much rounder. You can see here this is a quite cohesive silicone. It’s not really runny. So it’s second or third generation silicone.

Here you can see that I’ve actually fully opened the capsule now. There’s the implant partially deflated, and it was a 280 cc implant with a textured shell as you can see.

The next stage is to ascertain the optimum fill volume for the new implant. I do that by inserting a temporary inflatable implant, as you can see here. I blow that up with my syringe little by little. You remember I removed a 280 cc implant in this case, and I’m actually filling up to gauge the volume that will adequately fill the breast envelope there. It’s normally a little bit larger than the implant you removed because of the extra space you’ve created by freeing everything up and removing the implant and the capsule. In this case, I gauge that the optimum fill volume is a 330 cc implant.

Here I am I’ve cleaned the skin with the iodine, put the antibiotics in, and then I’m just putting the implant in through that hole. This is, as I said, a 330 cc implant.

Here I am just sewing up the skin, which I use subcuticular absorbable stitches as I’ve shown you in other videos.

Here you can see the differences between the two sides. On the right side, I’ve removed the capsule and the implant and you can see much less distortion than the left. On the left I haven’t operated on yet, but I’m going to perform exactly the same procedure on that side, removing the capsule, total capsule and the implant.

Here you are. This is the appearance at the end. The bra is fitted at the end of the procedure.

Thank you very much for watching the video and a big thank you to the patient for letting us show the video. I hope you found it useful and informative. If you’d like any more information about this or any other plastic and cosmetic procedure, please feel free to contact us either via our website, which is Aurora-Clinics.co.uk or by phoning us directly on our UK number 01844 214362. Thanks.